Syllabus: Continuous Quality Improvement, Fall 2017

Syllabus: Continuous Quality Improvement, Fall 2017

NEW YORK UNIVERSITY

Robert F. Wagner School of Public Service

EXEC-GP 2811-001

GPH-GU 2425-001

HPAM-GP 2825-001Continuous Quality Improvement Fall 2017

Dates: Tuesdays September 5, 2017 – December 15, 2017

Time: 6:45PM - 8:25PM

Location: 60 Fifth Ave, Room C04

Instructor: Alan Wikler, Psy.D.

Email:

Office Hours: by appointment at the Puck Building, 2nd floor, 295 Lafayette St. at Houston Street

or by SkypeTM: Contact name: awikler

Responsibilities and Expectations:

Content and grading are based primarily on classroom lectures, interactive discussions and group exercises. As such, students are expected to attend every scheduled class, be attentive, question and comment, form task-oriented teams of 5-6 students, and contribute to team tasks. Homework will consist of completion of team assignments. Some reading materials will be provided, mostly for students with the time and interest to delve deeper into the material, but are not required reading. Due to the emphasis on group tasks outside as well as in the classroom, students must be willing to share appropriate contact information with other course students, honoring reasonable boundaries for contact agreed upon by each team.

All students are responsible for adhering to the Wagner Schools general policy on incomplete grades, academic honesty, and plagiarism. It is each student’s responsibility to become familiar with these policies. All students are expected to pursue and meet the highest standards of academic excellence, and integrity.

• NYU Wagner Student Policies:
• Incomplete grades:
• Academic integrity:

Course Description:

Making sure that all patients in a healthcare system are receiving the highest quality of care and services is the responsibility of every healthcare provider, manager and leader. The healthcare industry is every changing and increasingly competitive. Simultaneously in recent decades there has been an increasing awareness of significant risks associated with healthcare. As a result, it is incumbent upon healthcare systems to develop increasingly effective methods of assuring quality healthcare, a positive experience for the patient and his/her family, and the detection and mitigation of the risks associated with modern healthcare. Beyond the moral and ethical obligation to do so, continuous quality improvement and focus on positive patient experiences is necessary for healthcare organizations to remain viable in an increasingly competitive market.

The aim of this course is to familiarize the student to the context and history of continuous quality improvement, the ways that that quality is assessed quantitatively and qualitatively, knowledge of performance improvement methodology development over time, with an emphasis on state-of-the-art and evolving methods, development of management-level critical thinking in healthcare problem solving, from day to day situations to organizational strategic priorities.

Learning Objectives:

-Upon successful completion of this course, students will be able to:

- Appreciate the need for continuous improvement as it relates both to the patient and the healthcare organization

- Understand and shape organizational culture that both drives and hinders change, with a understanding of the need for transparency and a "just culture'

- Know a variety of methodologies for improvement and make appropriate selectionsto in relation to the opportunities for improvement

- Apply one or more systematic approaches to improvement work, with an emphasis on team-based processes using Lean/Six Sigma Methodology

- Translate measurement numbers into actionable data, build a business care for improvement, set goals, derive root causes, formulate and test appropriate solutions and make sustainable process changes

Learning Methods:

- Interactive classroom lectures/discussions intended to challenge the student to develop problem-solving skills as well as accomplish subject matter understanding and transfer of knowledge

-Discussion of relevant case studies

- Contribution to team-based simulated improvement projects in which methods of creating a project charter, data collection, graphic representation of data and healthcare processes, root cause analysis, making small tests of change using the PDSA method, and implementation of sustainable solutions will be practiced and learned.

- Use of audio-visual aids as appropriate

-Optional (non-required) readings are offered as supplemental resources for further learning:

Readings:(encouraged for deeper understanding but NOT required):

Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition; Graban, Mark, Productivity Press, 2011

To Err is Human: Building a Safer Health System, Institute of Medicine,National Academy Press, 1999

Doing More with Less Lean Thinking and Patient Safety in Health Care 1st Edition, Joint Commission, Joint Commission Resources; 2006

Dr. Deming: The American Who Taught the Japanese about Quality; Aguayo, Rafael, Touchstone, 1991

On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry, Lean Enterprise Institute, Inc., 2010

The Lean Six Sigma Pocket Toolbook: A Quick Reference Guide to 100 Tools for Improving Quality and Speed; George, M.L.; Maxey, J.; Rowlands, D.; and Price, M.; McGraw-Hill Education, 2004

The Certified Six Sigma Green Belt Handbook, Second Edition; Munro, R.A.; American Society for Quality; 2015

Grading:

25%: Class participation: attendance, interaction with instructor, participation in team classroom projects

25% Contribution to weekly group projects: equitable contribution to project, communication with other students,

25% Group project presentation in the classroom: demonstration of understanding of key concepts, correct use of tools, evidence of critical thinking, and capacity to gain deeper understandingand utilize learning opportunities

25% Presentation of completed group projects: equitable participation in presentation, quality of project as a whole, openness to feedback. Demonstration of understanding of the process and presentation tools. Public speaking comfort and skills differ are not part of the aims of the class and will not be evaluated.

Course Outline

Class / Date / Topics / Assignments Homework and Deliverables due at Next Class
1 / 9/5 / Framework: The need for of continuous improvement, improvement to meet the needs of healthcare consumers and healthcare organizations, the dangers of healthcare, the need for a culture of safety and systematic and continuous improvement, review of syllabus and student responsibilities, communication between students and between instructor and students. / None
2 / 9/12 / Historical, regulatory, and discipline-specific approaches to healthcare improvement: Joint Commission, Center for Medicare and Medicaid Services, peer-review, Mortality and morbidity conferences, Nursing staffing effectiveness, / None
3 / 9/19 / Introduction to Lean, Six sigma, Lean Six Sigma (LSS), LSS DMAIC and A3 thinking. Observing the process and Value, streams, value stream analysis, focusing on customer needs and expectations, the voice of the customer and the voice of the process. Breaking into teams and team selection of projects Establishing communication between team members / Establish out-of-class communication,
Team assignment: Voice of the customer and voice of the process statements
4 / 9/26 / Defining the problem: Creating a team charter: Building a business case, aims, metrics, goals, scope process beginning and end, milestones and team membership / Team assignment: Team charters
5 / 10/3 / Review of team assignments: team charters. New: Operational definitions, strategic alignment; Introduction to discovering the process: Gemba observation, mapping and quantifying the current state and target state / Team assignment: Current state Process flow charts (current and target states) and baseline metrics
6 / 10/10 / Review of team assignments: Process flow map assignment and baseline metrics. New: identifying waste, barriers, bottlenecks, performing a gap analysis, root cause analysis using the 5 whys or fishbone analysis / Team assignment: Gap analysis with root cause analysis
7 / 10/17 / Review of assignment: gap analysis with root cause analysis. New: Countermeasures/solutions, error-proofing, selecting rapid tests of change PDSAs using a prioritization grid, conducting PDSAs / Team assignment: Countermeasures/solutions and a prioritization grid
8 / 10/24 / Review of team assignments: countermeasures/solutions and Prioritization grid. New:Conducting PDSA / Team assignment: PDSAs
9 / 10/31 / Review of team assignments: PDSAs. New: implementing sustainable solutions, failure mode and effects analysis, the completion plan / Team assignment: the completion plan
10 / 11/7 / Review of team assignments: the completion plan. New: sustaining improvement, Standard Work document, data control plan, auditing standard work / Team assignment: the Standard Work Document
11 / 11/14 / Review of team assignments: the Standard Work Document. New: spreading process change, quantifying return on investment (ROI) / Team assignment: return on investment
12 / 11/28 / Review of team assignments: return on investment. New: Documentation and celebration of lean improvement projects, the project slide deck and oral project review / Team Assignment: Begin to assemble Fifteen minute oral team “project Review” from past team assignments, documentation in the project slide deck
13 / 12/5 / Review of team assignments: Q&A, Use of the project “slide deck: New: Other lean improvement trends: 5S projects, Rapid Process Improvement Events RPIEs), Continuous daily improvement & huddle boarding, spreading a culture of lean / Team Assignment: Prepare oral Project Review with all team members contributing equally.
14 / 12/13 / Putting it all together: Use of class time to prepare team project reviews, class discussion of common questions and barriers, feedback from peers and instructors / Team Assignment: Finalize and rehearse team project review presentations
(Finals) / 12/20 / In class: team project oral project review Presentations, discussion, peer and instructor feedback and celebration of projects / Team Assignment (optional): informal celebration of projects and networking

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